Pyridoxamine Promising in Enhancing Bone Health and Reducing HbA1c in Older Women with Type 2 Diabetes: Study

Patients with type 2 diabetes experience reduced bone turnover and an increased risk of fractures. Advanced glycation end products (AGEs) impair osteoblast function and are linked to diabetic fractures. Pyridoxamine (PM), a metabolite of vitamin B6, inhibits AGE formation. Given this, Mishaela R Rubin, Metabolic Bone Disease Unit, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY, USA, and colleagues hypothesized that PM treatment in older patients with T2D could enhance bone formation by inhibiting AGEs.

For this purpose, the researchers conducted a double-blind randomized controlled trial at an academic center, involving 55 older women with type 2 diabetes. Participants received 200 mg of oral pyridoxamine twice daily for one year.

The primary outcome was the change in the bone formation marker P1NP. Secondary outcomes included changes in bone resorption, bone mineral density (BMD), HbA1c, and skin autofluorescence (SAF). In a subgroup undergoing bone biopsy, the researchers also examined the correlation between bone fluorescent AGEs (fAGEs) and SAF. The safety of pyridoxamine was assessed by monitoring neurologic symptoms and adverse events, as high doses of the parent vitamin B6 have been associated with neurotoxicity.